Respiratory Distress Syndrome

What Is Respiratory Distress Syndrome?

Respiratory distress syndrome (RDS) is a breathing problem that affects newborns,
mostly those who are born more than 6 weeks early. The earlier
a baby is born, the more likely the baby will have RDS.

Many babies get better in 3 to 4 days. Those who are very premature may take longer
to recover.

What Are the Signs & Symptoms of Respiratory Distress Syndrome?

Within minutes or hours of being born, a baby with RDS will have breathing problems.
These problems get worse over time, and include:

fast breathing

noisy breathing or grunting

retractions (a tugging in of the muscles between the ribs, under the ribcage,
and at the neck) while trying to breathe

a blue tint in the lips, nailbeds, and skin from lack of oxygen, called
cyanosis

What Happens in Respiratory Distress Syndrome?

RDS happens when a baby's lungs don't make
enough of a fatty substance called surfactant (ser-FAK-tent).

Surfactant is made in the last few weeks
of pregnancy. It helps tiny air sacs in the lungs called alveoli
(al-VEE-oh-lye) open more easily. These sacs fill with air when a baby breathes after
birth. Surfactant also helps keep the alveoli open when air leaves the lungs.

So, when a baby with RDS tries to breathe:

many of the alveoli cave in and can't open

oxygen can't get to the blood

carbon dioxide can't leave the body

If untreated, this can damage a baby's brain and other organs.

How Is Respiratory Distress Syndrome Diagnosed?

A doctor will suspect RDS in a premature baby who has trouble breathing soon after
birth. A chest X-ray of the lungs can
confirm the diagnosis.

How Is Respiratory Distress Syndrome Treated?

To help prevent respiratory distress syndrome, doctors can give steroid medicines
to pregnant women who are likely to deliver their babies early. Steroids help the
baby's lungs mature and make more surfactant before the baby is born.

Doctors give oxygen to a newborn who has trouble breathing. A baby who gets extra
oxygen but still struggles to breathe might need continuous positive airway pressure
(CPAP). With CPAP, a baby wears a special
nasal cannula
or a mask around the nose while a machine continuously pushes a stream
of air or oxygen into the nose. CPAP opens the alveoli and keeps them from collapsing.
Sometimes, a baby with RDS will need to be on a breathing machine (ventilator).

Babies with RDS may need treatment with surfactant. Doctors give surfactant through
a breathing tube directly into the lungs.

Babies with RDS are cared for in a neonatal
intensive care unit (NICU). In the NICU, a
team of experts — including doctors who specialize in newborn care (neonatologists),
nurses, and respiratory therapists (who help with breathing) — give treatment.

Many babies get better within 3 to 4 days, as their lungs start to make surfactant
on their own. Some babies — especially very premature babies — will need longer treatment
until they can breathe on their own.